A Randomized Trial of Focused-Ultrasound Subthalamotomy for Parkinson Disease

Treatment resulted in more motor improvement than sham procedures but caused an unexpected number of adverse effects.

Focused ultrasound, an imaging-guided technique that can be used to create brain lesions, is FDA approved for use in thalamotomy to treat Parkinsonian tremors. To test the technique in subthalamotomy, investigators randomized 40 patients (mean age, 58) with markedly asymmetric Parkinson disease (PD) 2:1 to focused ultrasound subthalamotomy (on the contralateral side to their main motor signs) or to a sham procedure. The study was partially manufacturer-sponsored. The primary efficacy outcome was a between-group difference in change from baseline to 4 months in the Movement Disorder Society–Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score. The outcome was based only on the scores corresponding to the side of the body opposite…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)